Ask a Lymphedema Expert Archive

Welcome to the Lymphedema Management Ask an Expert question and answers archive. If you would like to submit your own question click here.

Is your lymphedema program for people who have gotten lymphedema through cancer treatments or is it also for people who have lymphedema from it being in a family gene?

We welcome patients with secondary lymphedema as from cancer, and certainly those with primary lymphedema that may be genetic or may be non-familial. When someone is either born with symptoms or develops them as destined later in childhood or young adult, it is important to treat and help reduce swelling and/or prevent progression of the symptoms. On a patient's first visit, she is usually first assessed by our medical director, Dr Alan Kimmel. The team is ready to provide the level of treatment appropriate for the situation.

Regards,

Virginia Moratz, OTR CHT CLT

I am sure that I have lipidema with lymph edema in my legs(both). I use a compression machine every night alternating legs each night. I have tried custom made compression stockings , but they hurt so bad at the ankle, I do not tolerate them at all. There does not seem to be any physician in the Tidewater area who knows about lipidema. Would an appointment with your clinic be of any benefit to me?

The challenge at the ankle for those wanting to wear compression garments is tough when lipedema is involved as often the ankle and foot are not swollen. We have had success with careful selection of garment styles and referral to experienced fitters. Garments can remain an important component for your care. There are medical issues that may play a part in your condition. Dr. Alan Kimmel at our Center would be able to advise you. It is a distance for you to travel, it may be helpful to have a team assessment as well in the same trip. Look forward to your call.

Virginia Moratz, OTR CHT CLT

I am researching Lymphedema Treatment along with my physical therapist. The treatment is for myself as I have been dealing with this for a very long time and it is aggressively getting worse. Is your program an inpatient program? What needs to be done to be referred?

Our Lymphedema & Rehabilitation program is on an outpatient basis. We have a team approach with a physician, nurse and therapists, all trained and very experienced in the care of lymphedema. The multi-discipline approach allows for identification of factors and a specific treatment recommendation. For those traveling for a consult from out-of-state, we certainly make recommendations to the treating therapist and serve as a resource. For those where receiving treatment is convenient to our Center, we develop a treatment schedule. Our web site at www.GBMC.org/lymphedema may provide you with further information. Feel free to email further questions or call.

I had a melanoma tumor removed from my right armpit in 1986, along with about 70% of the lymph nodes. I had no other treatment and have been fine for the last 27 years. Now I have swelling in my right arm & am being treated with antibiotics provided by an ER doc. What type of doctor should I follow-up with to determine if I just have edema or lymphedema? My primary care doc is not very familiar with this condition.

It can be very important to follow-up now with a specialist therapist and physician. In some locations you are more apt to find a certified lymphedema therapist than a physician specialized in lymphedema. There are organizations such as the National Lymphedema Network (NLN) that list providers. There are schools for lymphedema therapists that have a directory.

GBMC would be very ready to address your individual needs and questions. Our Lymphedema & Rehabilitation Center is unique in having our Medical Director, Dr. Alan Kimmel who is highly experienced in lymphedema care available for appointments as well as having specialized therapists.

You are not alone in swelling only declaring itself after a bout with infection. The lymph nodes are an important part of the bodies defense, and as you have discovered, the arm and sometimes same side chest area are vulnerable to cellullitis. Assisting your lymphatic flow as your arm recovers and helping to prevent recurrent infection would be the intent of intervention. Your primary care physician, oncologist or surgical oncologist would be copied on any recommendations and progress, if you so approve.

My mom has been diagnosed with venous status. She is currently receiving home health care. Would an evaluation at the lymphedema clinic be helpful?

Venous stasis can lead to swelling in the legs that is uncomfortable. The swelling can be called lymphedema when that swelling stagnates. Either way, the Lymphedema & Rehabilitation Center's Medical Director, Dr. Alan Kimmel certainly evaluates and makes recommendations to control or minimize the symptoms for patients with venous insufficiency. It sometimes is very important to have compression garments to wear for the control of the swelling and to support the function of the veins. It can also be important to review medications that may have a side effect of fluid retention. If there is an acute onset of pain and swelling that may be more of an emergency and needs to be evaluated by a vascular specialist or sometimes at the emergency room.

I am going to p.t. this morning for a neck and shoulder injury sustained in an auto accident. Can they use heat or electronic stimulation?

When someone has lymphedema we suggest that one avoid extremes of heat as heat tends to increase fluid in the area. The shoulder, the breast and the arm, hand and fingers all are in the same lymphatic region. The suggestion is to discuss with your physical therapist who is treating your shoulder and neck whether the hotpacks are vital to your outcome. Cool compresses to follow the therapy is advised to normalize temperatures in the tissue and for pain relief. There is some literature that suggests it is best to avoid the use electrical stimulation and therapeutic ultrasound in regions where there is a history or presence of cancer.